ER Waiting Times Linked to Higher Adverse Events Risk

No increased risk of adverse events for patients who leave without being seen

THURSDAY, June 2 (HealthDay News) -- Patients who present to emergency departments during shifts with long mean waiting times are at increased risk for adverse events, according to a study published online June 1 in BMJ.

Astrid Guttmann, M.D.C.M., from the Institute for Clinical Evaluative Sciences in Toronto, and colleagues examined whether patients who attended an emergency department during shifts with long waiting times, but were not admitted to hospital, were at risk for adverse events. Data from 13,934,542 patients attending high-volume emergency departments in Ontario, between 2003 and 2007, including 617,011 patients who left without being seen, were collected from health administrative databases.

The investigators found that, as the duration of stay of similar patients in the same shift in the emergency department increased, the risk of adverse events increased. For a mean length of stay of six hours or more compared with less than one hour, for high acuity patients the adjusted odds ratio (OR) for death was 1.79 and for admission was 1.95; and for low acuity patients, the OR for death was 1.71 and admission was 1.66. There was no association between leaving without being seen and an increase in adverse events per patient or per year.

"Presenting to an emergency department during shifts with longer waiting times, reflected in longer mean length of stay, is associated with a greater risk in the short term of death and admission to hospital in patients who are well enough to leave the department," the authors write.